Multidetector computed tomography in the preoperative staging of gastric adenocarcinoma

Abstract

ObjectiveTo evaluate the role of multidetector computed tomography in the preoperative investigation of tumor invasion depth and lymph node and metastatic involvement according to the TNM classification, in patients with gastric adenocarcinoma.Materials and MethodsFifty-four patients with biopsy-confirmed gastric cancer underwent preoperative staging with 64-channel multidetector computed tomography. Two independent radiologists analyzed the images and classified the findings. Sensitivity, specificity, accuracy and overall accuracy were calculated for each observer. The interobserver agreement was also evaluated.ResultsThe accuracy in the classification of categories T ranged from 74% to 96% for observer 1 and from 80% to 92% for observer 2. The overall accuracy was 70% for both observers. The weighted kappa index was 0.75, consistent with a significant interobserver agreement. The accuracy in the classification of lymph node involvement (category N) ranged from 55% to 79% for observer 1 and from 73% to 82% for observer 2. The evaluation of metastatic involvement showed an overall accuracy of 89.6% for both observers.Conclusion64-channel multidetector computed tomography demonstrated clinically relevant accuracy in the preoperative staging of gastric adenocarcinoma as regards invasion depth (T category) and metastatic involvement (M category).

<p>FKBP10 Acts as a New Biomarker for Prognosis and Lymph Node Metastasis of Gastric Cancer by Bioinformatics Analysis and in Vitro Experiments</p>

“…Various examination methods have limitations in the diagnosis of gastric lymph node metastasis. [21][22][23][24] Figure 4 Gene set enrichment analysis (GSEA) result of FKBP10. (A-C)"KEGG_ADHERENS_JUNCTION","KEGG_ECM_RECEPTOR_INTERACTION","KEGG_FOCAL_ ADHESION","KEGG_GLYCOSAMINOGLYCAN_BIOSYNTHESIS_CHONDROITIN_SULFATE","KEGG_PATHWAYS_IN_CANCER","KEGG_TGF_BETA_SIGNALING_PATH WAY" were enriched in the three independent cohort.…”

“…Various examination methods have limitations in the diagnosis of gastric lymph node metastasis. 21 – 24 Currently, there are no effective molecular predictors that could be used to predict lymph node metastasis in GC. In this study, we screened out FKBP10 as a potential marker for lymph node metastasis in GC using online data analysis.…”

Diagnosis of gastric cancer by MDCT gastrography: diagnostic characteristics and management potential

“…In our study, gastric tumor enhancement was identified in all patients in the arterial phase, all of them show homogenous enhancement. On MDCT, the extension of tumor load was categorized as follows: T0, no proof of alteration of the gastric wall with even perigastric fat around; T1, infiltration of the gastric mucosa or submucosa [16]; T2, invasion to muscularis propria [17]; T3, invasion to subserosa [16]; and T4, invasion to serosa and adjacent organs or structures [18,19].…”

Is Accurate N – Staging for Gastric Cancer Possible?

“…However no worldwide consensus exists. Except of size, the other qualitative criteria are applied at the discretion of the radiologist leading to significant intraobserver variability ( 11 ).…”

“…An equilibrium between specificity and sensitivity exists, depending on the selected size threshold. In other words choosing a smaller threshold as pathologic will increase sensitivity at the expense of specificity and vice versa ( 11 ). More or less other criteria suffer from similar limitations.…”